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Simulated comparison of topical and oral formulations of 5-aminosalicylate for the treatment of ulcerative colitis
Inflammatory Bowel Disease, 06/15/2012
Clinical Article
Stobaugh DJ et al. – Compared to Asacol, Lialda results in higher 5–ASA amounts in the left colon. Asacol with Rowasa provides highest 5–ASA amounts across the entire colon. Higher 5–ASA amounts from topical formulations occur when the insertion occurs soon after the daily bowel movement. This model provides a rationale for further investigation.
Methods- The authors created a model with Stella software.
- Colonic 5–ASA in the right, transverse, descending, sigmoid colon, and rectum were estimated for adults after recommended doses of the above formulations.
- Simulations of active mild/moderate UC and in remission were performed and compared using Student's t–test for differences in means.
- For UC in remission, the highest amounts of 5–ASA were from Asacol in the right and transverse colon (P<0.01), Lialda in the descending and sigmoid colon (P<0.01), and Rowasa in the rectum (P<0.01).
- For active UC, sigmoid amounts were highest with foam (P<0.01), and rectal amounts highest with Rowasa (P<0.01).
- Differences in rectosigmoid amounts of 5–ASA from enemas and suppositories for UC in remission occurred based on the relationship between the timing of administration relative to the daily bowel movement (P<0.01).
